wspar_022108 - TOWNSHIP OF ADJALA-TOSORONTIO Application for Minor

TOWNSHIP OF ADJALA-TOSORONTIO
Application for Minor Variance of for Permission
NOTICE
It is the responsibility of each applicant to ensure that their application is fully completed
with all necessary documents, according to the instructions attached to each application on
Page 11. The detailed sketch is a very important part of each application.
Any comments made by the Municipal Office Staff will not have any bearing on the decision
of the Committee of Adjustment as it is the responsibility of each applicant to see that all
facts are submitted with the application.
FEES TO BE SUBMITTED AT TIME OF APPLICATION
Application Fee for Minor Variance $400.00
Fee for sign which must be posted as required by the Planning Act $20.00
Fee for review by the Nottawasaga Valley Conservation Authority $200.00
(if subject lands fall within their area of interest) (cheque to be made
out to the Authority – this may not be required, therefore check with
Planning Staff prior to making out the cheque)
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DECLARATION OF INTENT
I/We ____________________________________________ [owner(s)/applicant/agent] hereby declare that,
as required under the Planning Act, Ontario Regulations 504/98, 505/98, 506/98, 507/98 or 508/98 (whichever
is applicable), I/we will post the sign provided by the Township of Adjala – Tosorontio on the lands subject to
the application in a location that is legible and visible from the roadway and for the required length of time as
provided for under the Planning Act (currently for minor variance applications it would be posted 10 days
prior to the date of the public meeting).
I/We also agree to pay to the Township a fee of $20.00 non-refundable for the sign.
(If the Owners of the subject lands are represented by an agent, the agent may pay the fee on their behalf).
NOTE: IF THE SIGN IS NOT POSTED THE REQUIRED AMOUNT OF TIME PRIOR TO THE
MEETING, THEN THE COUNCIL MAY CHOOSE NOT TO HEAR THE APPLICATION ON
THAT DATE.
____________________________________________
(owner/applicant/agent)
____________________________________________
(owner/applicant/agent)
Dated the ____________ day of __________________________________, 2010.
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TOWNSHIP OF ADJALA-TOSORONTIO
APPLICATION FOR MINOR VARIANCE OR FOR PERMISSION
UNDER THE PLANNING ACT, R.S.O. 1990 FILE: A
The undersigned hereby applies to the Committee of Adjustment for the Township of Adjala – Tosorontio
under section 45 of the Planning Act, R.S.O 1990 for relief, as described in this application, from By-law 03-57,
as amended or By-law 76-4, as amended (formerly Township of Adjala).
1. Name of Owner -
Telephone Number -
2. Address -
Email -
3. Name of Agent (if any) -
Telephone Number -
4. Address -
Note: Unless otherwise requested, all communications will be sent to the agent, if any.
5. Names and addresses of any mortgagees, holders of charges or other encumbrances:
6. Nature and extent of relief applied for: (Please provide section and dimensions)
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7. Why is it not possible to comply with the provisions of the By-laws? (Topography of lands,
area of lands, other constraints) PLEASE BE VERY SPECIFIC
8. Location of Lands:
Legal Description Lot No. Concession No. Former Township
Registered Plan No. Concession No.
Reference No. Part No.
Roll No.
Street Address:
9. Dimensions of land affected:
Frontage -
Depth -
Area -
Width of Street -
10. Particulars of all buildings and structures on or proposed for the subject land (Specify ground floor
area, gross floor area, number of storeys, width, length, height, etc.):
Existing:
Proposed:
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11. Location and type of all buildings and structures on or proposed for the subject land (Specify distance
from side, rear and front lot lines):
Existing:
Proposed:
12. Date of acquisition of subject land:
13. Date of construction of all buildings and structures on subject land:
14. Existing uses of the subject property:
15. Existing uses of abutting properties:
16. Proposed uses of the subject property:
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17. Length of time the existing uses of the subject property have continued:
18. Identify the how the property will be serviced:
Proposed for the Subject Land: (Check Appropriate Box(es))
Access: Provincial Highway Municipal road, maintained all year Municipal road,
seasonally maintained
Other public road Right of way Other ____________
Describe the parking facilities to be used and the approximate distance of these facilities
between the subject land and the nearest public road.
Publicly owned and Privately owned and operated Privately owned and
Water operated piped water individual well operated communal well
Supply: system
Lake or other water Other means (describe)
body
Sewage Publicly owned and Privately owned and operated Privately owned and
Disposal: operated sanitary individual septic tank
1,2 operated communal
sewage system septic system
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Privy Other means (describe)
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A certificat of approval from the Building Department of Ministry of the Environment and
Energy submitted with this application will facilitate the review.
2 Development utilizing this method of effluent disposal producing more than 4500 litres/day
of effluent are required to submit a servicing options report and a hydrogeological report in
support of this application
Storm Municipal Sewers Ditches Swales
Drainage
Other ___________________
19. Present Official Plan policies applying to the land (Designation(s)):
20. Present Zoning By-law provisions applying to the land (Zone(s)):
21. Has the owner previously applied for relief in respect of the subject property?
[ ] Yes [ ] No
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If the answer is yes, describe briefly:
22. Is the subject property the subject of a current application for consent under section 53(1) of the
Planning Act, 1990? [ ] Yes [ ] No
23. Affidavit or Sworn Declaration
23.1 Affidavit or Sworn Declaration For the Prescribed Information
I/We, of the
in the make
oath and say (or solemnly declare) that the information contained within this application is true and that the
information contained in the documents that accompany this application in respect of the above Sections
is true.
Sworn (or declared) before me
at the
in the
this day of , 2010.
Commissioner of Oaths Applicant
Applicant
23.2 Affidavit or Sworn Declaration For Requested Information
I/We, of the
in the make
oath and say (or solemnly declare) that the information contained within this application is true and that the
information contained in the documents that accompany this application in respect of the above Sections
is true.
Sworn (or declared) before me
at the
in the
this day of , 2010.
Commissioner of Oaths Applicant
Applicant
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24. Authorizations
24.1 If the applicant is not the owner of the land that is the subject of this application, the written
authorization of the owner(s) that the applicant is authorized to make the application must be
included with this form or the authorization set out below must be completed.
Authorization of Owner(s) for Agent
to Make the Application
I/We, , am/are the owner(s) of the land that
is the subject of this application for a minor variance and I/We authorize
to make this application on my/our behalf.
Date Signature of Owner
Signature of Owner
24.2 If the applicant is not the owner of the land that is the subject of this application, complete the
authorization of the owner(s) concerning personal information set out below.
Authorization of Owner(s) for Agent
to Provide Personal Information
I/We, , am/are the owner(s) of the land
that is the subject of this application for a minor variance and for the purposes of the Freedom of Information
and Protection of Privacy Act, I/We authorize , as my/our agent for this
application, to provide any of my/our personal information that will be included in this application or collected
during the processing of the application.
Date Signature of Owner
Signature of Owner
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25. Consent of the Owner(s)
25.1 Complete the consent of the owner (s) concerning personal information set out below.
Consent of the Owner(s) to the Use
and Disclosure of Personal Information
I/We, , am/are the owner(s) of the land that is the subject of
this consent application and for the purposes of the Freedom of Information and Privacy Act, I/We
authorize and consent to the use by or the disclosure to any person or public body of any personal
information that is collected under the authority of the Planning Act for the purposes of processing this
application.
Date Signature of Owner
Signature of Owner
25.2 Complete the consent of the owner(s) concerning permission for municipal staff and Committee of
Adjustment Member to enter onto the subject lands for the purposes of inspecting the lands with
regards to the application.
Consent of the Owner(s) for
Municipal Staff and Committee of Adjustment Members
to enter onto the subject lands for the purpose of inspecting the lands
to evaluate the merits of the application
I/We, am/are the owner(s) of the land that is the subject of this
consent application and giver permission to Municipal Staff and the Committee of Adjustment Members to
enter onto the subject land for the purpose of inspecting the lands to evaluate the merits of the application.
Date Signature of Owner
Signature of Owner
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NOTES:
1. It is required that 1 copy of this application and 15 copies of the Plan of the Lot be filed with the
Secretary/Treasurer of the Committee of Adjustment, together with the plan referred to in Note,
accompanied by a fee of $400.00 (non refundable) in cash or by cheque made payable to the
Treasurer of the Township of Adjala-Tosorontio. You will also be required to pay a fee of $20.00
for a sign which is required to be posted under the Planning Act. You may also be required to
pay a fee of $75.00 if a septic review is required relating to this application.
2. Each copy of this application must be accompanied by a plan showing the dimensions of the subject
land and of all abutting land and showing the location, size and type of all buildings and structures on
the subject and abutting land. The Committee of Adjustment may require that the plan be signed by
an Ontario Land Surveyor.
3. The application shall be accompanied by a sketch showing the following:
• The boundaries and dimensions of the subject land;
• The location and size and type of all existing and proposed buildings and structures on the subject
land, indicating their distance from the front lot line, rear lot line and side lot lines;
• The approximate location of all natural and artificial features (for example, buildings, railways, roads,
watercourses, drainage ditches, banks of rivers or streams, wetlands, wooded areas, wells and
septic tanks) that,
o Are located on the subject land and on land that is adjacent to it, and
o In the applicant’s opinion, may affect the application;
• The current uses of land that is adjacent to the subject land;
• The location, width and name of any roads within or abutting the subject land, indicating whether it is
an unopened road allowance, a public traveled road, a private road or a right of way;
• If access to the subject land will be by water only, the location of the parking and docking facilities to
be used;
• The location and nature of any easement affecting the subject land;
• The boundaries and dimensions of any land owned by the owner of the subject land that abuts the
subject land; and
• The approximate distance between the subject land and the nearest Township lot line or landmark,
such as a railway crossing or bridge.
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OWNER:
LOCATION OF PROPERTY:
ACREAGE: FILE NO. A DATE:
All sketches must be to scale with the scale noted.
Trees: Deciduous and Coniferous
Ponds/marsh/swamps:
Fence: -----X-----X-----X Highways:
Buildings: house shed barn
Rivers or Creeks: Other Roads: ------------ Railways: --------------------
Bridges/Culverts: Well(s): well Septic System(s): septic
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For Office Use Only:
1. To be completed prior to Hearing
(a) Date of receipt of completed application by Municipality
(b) Assessment Roll Number -
(c) Committee Submission Number -
(d) Checked by -
(e) Hearing Date -
(f) Zoning By-law Number -
(g) Official Plan Designation -
(h) Agricultural Land Use Classification in Canada
Land Inventory -
(i) Site Visit carried out by staff or committee member
yes - no -
(j) Authorization of owner received (if required)
yes - no -
2. (a) Date decision is made -
(b) Date decision is mailed -
(c) Last date for objections -
(d) Date Certificate for Minor Variance issued
(e) List of Objections received and date received:
(see attached)
(f) Date submitted to Ontario Municipal Board:
(g) Date of Municipal Board Hearing:
(h) Municipal Board Decision:
(see attached)
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